Transfer instrument

Abstract

A transfer instrument includes: a first position where first and second shafts are moved in a proximal end direction with respect to an outer cylinder such that a first support portion is retracted into the outer cylinder; and a second position where the first and second shafts are moved in a distal end direction with respect to the outer cylinder such that the first support portion protrudes from a distal-end opening of the outer cylinder, and the first support portion is unfolded by being exposed in the distal end direction from the outer cylinder. There is provided a movement regulation portion that regulates relative movement between the first shaft and the second shaft in an axial direction between the first position and the second position.

What is claimed is: 
     
         1 . A transfer instrument for transferring a medical sheet to a treatment site of a living body, the transfer instrument comprising:
 an outer cylinder;   a first carrier member including a first shaft that extends in an axial direction of the outer cylinder and is disposed inside the outer cylinder to be movable along the axial direction, and a first support portion that has a sheet shape, is disposed at a distal portion of the first shaft, and includes a support surface configured to hold the medical sheet when the distal portion of the first shaft is disposed in a distal end direction with respect to a distal portion of the outer cylinder; and   a second carrier member including a second shaft extending along the first shaft and provided movably along the first shaft;   wherein the first support portion is retracted into the outer cylinder in a state of being curved and deformed at a first position where the first shaft and the second shaft are moved in a proximal end direction with respect to the outer cylinder such that the first support portion is retracted into the outer cylinder;   the first support portion is unfolded by being exposed from the outer cylinder in the distal end direction at a second position where the first and second shafts are moved in the distal end direction with respect to the outer cylinder such that the first support portion protrudes from a distal-end opening of the outer cylinder; and   a movement regulation portion that regulates relative movement in the axial direction between the first shaft and the second shaft by bringing the first support portion and a distal portion of the second shaft into contact with each other between the first position and the second position.   
     
     
         2 . The transfer instrument according to  claim 1 , wherein
 the movement regulation portion is a pressure-application portion configured by the distal portion of the second shaft; and relative displacement between the first support portion and the second shaft is restricted by the pressure-application portion pressing the first support portion against an inner surface of the outer cylinder in a state where the first support portion is retracted in the outer cylinder.   
     
     
         3 . The transfer instrument according to  claim 2 , wherein
 in a cross section orthogonal to an axis of the second shaft, a cross section of the pressure-application portion includes a pair of linear portions orthogonal to an axis of the second shaft, and a pair of convex-shaped portions that are disposed on both sides of the pair of linear portions and are convex in a direction away from the linear portions; and   a first length of the pressure-application portion along an extending direction of the linear portions is longer than a second length of the pressure-application portion orthogonal to the extending direction.   
     
     
         4 . The transfer instrument according to  claim 1 , wherein
 the movement regulation portion includes a first fitting portion provided to the first support portion and a second fitting portion provided to the distal portion of the second shaft;   relative displacement between the first support portion and the second shaft is restricted by fitting between the first fitting portion and the second fitting portion in a state where the first support portion is retracted in the outer cylinder; and   fitting between the first fitting portion and the second fitting portion is released by the first support portion being unfolded at the second position.   
     
     
         5 . The transfer instrument according to  claim 1 , wherein the movement regulation portion includes a first engagement portion provided on a front surface of the first support portion including the support surface and a second engagement portion formed at the distal portion of the second shaft;
 in a state where the first support portion is retracted in the outer cylinder, relative displacement between the first support portion and the second shaft is restricted by the first engagement portion and the second engagement portion facing each other in an axial direction of the second shaft and the first engagement portion and the second engagement portion being engaged with each other in the axial direction; and   engagement between the first engagement portion and the second engagement portion is released without the first engagement portion and the second engagement portion facing each other in the axial direction, by the first support portion being unfolded at the second position.   
     
     
         6 . The transfer instrument according to  claim 1 , wherein
 a second support portion having a sheet shape and including a second support surface configured to hold the medical sheet, the second support surface being provided on a distal portion of the second shaft, and   the second support portion is relatively movable with respect to the first support portion between a retracted position where the second support portion overlaps with the support surface and an advanced position where the second support portion is located in the distal end direction relative to the support surface.   
     
     
         7 . The transfer instrument according to  claim 6 , wherein
 at the first position, the second support portion is retracted inside the outer cylinder while being curved and deformed together with the first support portion.   
     
     
         8 . The transfer instrument according to  claim 6 , wherein
 a carrier holding portion that holds a proximal portion of the second support portion is provided to the distal portion of the second shaft,   in a cross section orthogonal to an axis of the second shaft, the carrier holding portion has a line-symmetrical shape with respect to an imaginary straight line passing through a center line of the carrier holding portion and parallel to a width direction of the carrier holding portion, and   the carrier holding portion holds the second support portion on the center line.   
     
     
         9 . The transfer instrument according to  claim 1 , wherein
 the first support portion is formed of a flexible sheet having a front surface including the support surface and a back surface that is a surface opposite to the front surface,   the first support portion includes a pair of protrusions protruding upward from both sides in a width direction of the support surface orthogonal to a moving direction of the first shaft, and   at the first position, the first support portion is retracted into the outer cylinder in a state of being curved and deformed such that both sides in a width direction of the first support portion on the back surface are in contact with each other.   
     
     
         10 . A transfer instrument for transferring a medical sheet to a treatment site of a living body, the transfer instrument comprising:
 an outer cylinder;   a first carrier member including a first shaft that extends in an axial direction of the outer cylinder and is disposed inside the outer cylinder to be movable along the axial direction, and a first support portion that has a sheet shape, is disposed at a distal portion of the first shaft, and includes a support surface configured to hold the medical sheet when the distal portion of the first shaft is disposed in a distal end direction with respect to a distal portion of the outer cylinder;   a second carrier member including a second shaft extending along the first shaft and provided movably along the first shaft; and   a movement regulation portion that regulates relative movement in the axial direction between the first shaft and the second shaft by bringing the first support portion and a distal portion of the second shaft into contact with each other between the first position and the second position.   
     
     
         11 . The transfer instrument according to  claim 10 , wherein
 the movement regulation portion is a pressure-application portion configured by the distal portion of the second shaft; and   relative displacement between the first support portion and the second shaft is restricted by the pressure-application portion pressing the first support portion against an inner surface of the outer cylinder in a state where the first support portion is retracted in the outer cylinder.   
     
     
         12 . The transfer instrument according to  claim 11 , wherein
 in a cross section orthogonal to an axis of the second shaft, a cross section of the pressure-application portion includes a pair of linear portions orthogonal to an axis of the second shaft, and a pair of convex-shaped portions that are disposed on both sides of the pair of linear portions and are convex in a direction away from the linear portions; and   a first length of the pressure-application portion along an extending direction of the linear portions is longer than a second length of the pressure-application portion orthogonal to the extending direction.   
     
     
         13 . The transfer instrument according to  claim 10 , wherein
 the movement regulation portion includes a first fitting portion provided to the first support portion and a second fitting portion provided to the distal portion of the second shaft;   relative displacement between the first support portion and the second shaft is restricted by fitting between the first fitting portion and the second fitting portion in a state where the first support portion is retracted in the outer cylinder; and   fitting between the first fitting portion and the second fitting portion is released by the first support portion being exposed from the outer cylinder in the distal end direction such that the first support portion protrudes from a distal-end opening of the outer cylinder.   
     
     
         14 . The transfer instrument according to  claim 10 , wherein
 the movement regulation portion includes a first engagement portion provided on a front surface of the first support portion including the support surface and a second engagement portion formed at the distal portion of the second shaft;   in a state where the first support portion is retracted in the outer cylinder, relative displacement between the first support portion and the second shaft is restricted by the first engagement portion and the second engagement portion facing each other in an axial direction of the second shaft and the first engagement portion and the second engagement portion being engaged with each other in the axial direction; and   engagement between the first engagement portion and the second engagement portion is released without the first engagement portion and the second engagement portion facing each other in the axial direction by the first support portion being exposed from the outer cylinder in the distal end direction such that the first support portion protrudes from a distal-end opening of the outer cylinder.   
     
     
         15 . The transfer instrument according to  claim 10 , wherein
 a second support portion having a sheet shape and including a second support surface configured to hold the medical sheet, the second support surface being provided to a distal portion of the second shaft, and   the second support portion is relatively movable with respect to the first support portion between a retracted position where the second support portion overlaps with the support surface and an advanced position where the second support portion is located in the distal end direction relative to the support surface.   
     
     
         16 . The transfer instrument according to  claim 15 , wherein
 a carrier holding portion that holds a proximal portion of the second support portion is provided to the distal portion of the second shaft,   in a cross section orthogonal to an axis of the second shaft, the carrier holding portion has a line-symmetrical shape with respect to an imaginary straight line passing through a center line of the carrier holding portion and parallel to a width direction of the carrier holding portion, and   the carrier holding portion holds the second support portion on the center line.   
     
     
         17 . The transfer instrument according to  claim 10 , wherein
 the first support portion is formed of a flexible sheet having a front surface including the support surface and a back surface that is a surface opposite to the front surface,   the first support portion includes a pair of protrusions protruding upward from both sides in a width direction of the support surface orthogonal to a moving direction of the first shaft, and   at a first position, the first support portion is retracted into the outer cylinder in a state of being curved and deformed such that both sides in a width direction of the first support portion on the back surface are in contact with each other.   
     
     
         18 . A method of transferring a medical sheet to a treatment site of a living body, the method comprising:
 placing a transfer instrument for transferring the medical sheet to the treatment site of the living body in an initial state, the transfer instrument including an outer cylinder, a first carrier member including a first shaft that extends in an axial direction of the outer cylinder and is disposed inside the outer cylinder to be movable along the axial direction, and a first support portion that has a sheet shape, is disposed at a distal portion of the first shaft and includes a first support surface, a second carrier member including a second shaft extending along the first shaft and provided movably along the first shaft, the second carrier member including a second support portion provided on a distal portion of the second shaft, and a movement regulation portion that regulates relative movement in the axial direction between the first shaft and the second shaft by bringing the first support portion and a distal portion of the second shaft into contact with each other between the first position and the second position;   placing the medical sheet on the second support surface;   retracting the medical sheet into the outer cylinder together with the first support portion and the second support portion to a retracted position;   inserting the transfer instrument inserted into the living body and positioning a distal end of the transfer instrument near the treatment site of the living body;   moving the first shaft and the second shaft in a distal end direction relative to the outer cylinder via the movement regulation portion, and unfolding the first support portion, the second support portion and the medical sheet; and   moving the second carrier member in the distal end direction relative to the first carrier member so that the second support portion on which the medical sheet is placed is moved from the retracted position to an advanced position, and wherein the second support portion protrudes in the distal end direction relative to the distal end of the first support portion to move the medical sheet to above the treatment site of the living body and bringing an overhanging portion of the medical sheet into contact with the treatment site of the living body.   
     
     
         19 . The method according to  claim 18 , further comprising:
 moving the second carrier member from the second position to the first position to withdraw the second support portion from between the treatment site and the medical sheet; and   withdrawing the transfer instrument from the living body with the first support portion and the second support portion retracted into the outer cylinder.   
     
     
         20 . The method according to  claim 18 , wherein the treatment site is a heart of the living body.